Low Testosterone in Women

Low Testosterone in Women: Causes, Symptoms, and Treatments

Testosterone is a hormone that is most commonly thought of as the male sex hormone. It is important for many aspects of health in men and women and also plays a role in diseases such as prostate cancer, coronary artery disease, and type 2 diabetes. [1][2]

But did you know that women produce testosterone, and testosterone plays a role in women's health as well? It is made in the ovaries and the adrenal cortex (the outer region of the adrenal gland).

The ovaries produce testosterone, as do the adrenal glands. Testosterone is then converted to estrogen. If the female body produces high testosterone levels, the body may have trouble converting it to estrogen, leading to hormone imbalance. Imbalanced hormone levels can have adverse effects on health.

Low testosterone levels in women can negatively affect bone density, muscle mass, hormonal balance, and more. We'll dive into the potential benefits of testosterone replacement therapy and its effect on testosterone production.

What are the symptoms of high testosterone in women? 

Your healthcare provider can perform a blood test to determine your testosterone levels. Normal testosterone levels in healthy women are 15 to 70 nanograms per deciliter of blood.

Too much testosterone can cause oily skin, deepening of the voice, reduced breast size, excess hair growth (including facial hair), and irregular periods. [3] Polycystic ovary syndrome (PCOS) is a common cause of high testosterone in women. Signs of PCOS include an irregular menstrual cycle, weight gain, low energy levels, and excessive hair growth—all of which are affected by hormone levels.

What are the symptoms of low testosterone in women?

Androgens are a group of sex hormones, including testosterone, androstenedione dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), and dihydrotestosterone (DHT). These (and other) hormones are responsible for bone density.

In females, androgens help regulate menstrual periods, minimize bone mass loss, and plays a vital role in conception.

While low testosterone can negatively affect men's health, this hormone imbalance can also affect women.

Androgen deficiency and low testosterone in women may cause women to have [4] :

  • low libido (decreased sex drive)

  • reduced bone strength

  • poor concentration

  • depression

Hypoactive sexual desire disorder (decreased sex drive) is one symptom of low testosterone levels. There are a few tests you can take to determine the cause of your reduced sexual functioning to get a better idea of it's due to low testosterone, or another cause. There is a test for the sex hormone binding globulin, which can help to determine your hormone balance. Along with this test, your doctor may prescribe a test for free testosterone levels. [5]

You can also work with your healthcare provider to assess your low libido using the female sexual function index. Treatments for hypoactive sexual desire disorder include sex therapy or medication.

In extreme cases, women with breast cancer have been found to have lower levels of testosterone in their saliva than those of a similar age without cancer. [6]

What happens to testosterone levels in post-menopausal women?

As women (and men) age, testosterone levels naturally decrease. In premenopausal women, low testosterone levels can present as depression, low libido, and muscle weakness. When a woman reaches menopause, her estrogen levels, and production decrease. Low estrogen can lead to loss of bone density and muscle mass and an increase in body fat. Low testosterone, especially in males, can be linked to an increase risk of cardiovascular disease. [7]

It's important to note that most current research on the effects of low testosterone centers around post-menopausal women who report decreased sexual desire after menopause.

What causes low testosterone in women?

There are a few main causes of low testosterone in women. As people age testosterone levels naturally decrease. Otherwise, issues with the pituitary gland, adrenal glands or ovarian failure can contribute to low testosterone in women. [8] Extreme exercise can also lead to decreased testosterone levels, however lack of exercise can also be attributed to low testosterone levels, so it's important to strike a happy medium when working toward a goal of increased muscle mass.

How can a woman increase testosterone levels?

If you have low levels of testosterone, one treatment option is testosterone replacement therapy. Treatment for low testosterone levels comes in many forms including gels, patches, pills or cream. [9]

Testosterone therapy can help to treat low testosterone in women, but it's important to note that to date, there is not much data on safety or efficacy. [10]

Another treatment for low testosterone is androgen therapy, which may be right for some post-menopausal women. But note, the treatment is a derivative of testosterone, not the hormone itself, so this treatment isn't right for everyone.

Female low testosterone may also be treated by injections of testosterone done by your licensed medical professional. Your doctor may prescribe over-the-counter DHEA supplements. (The Endocrine Society recommends against long-term DHEA use, as long-term side effects are not known. [11])

To help with hormone balance, your doctor may also work with you on a plan to eat a more healthful diet, work with you on a plan to ensure you are getting proper sleep. Depending on your current testosterone levels, including foods rich in protein, zinc, magnesium and B vitamins may help to keep your testosterone levels in the normal range.

However, to date there isn't much hormone research done to shed light on testosterone deficiency or the benefits of testosterone replacement in women. [12] Most testosterone therapy is not currently approved for use by the Food and Drug Administration (FDA). Before seeking out any treatment, be sure to seek professional medical advice from your healthcare provider.

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